Apnea of prematurity (AOP) is a common problem in preterm infants, which is often treated with nasal Continuous Positive Airway Pressure (nCPAP) or nasal intermittent Positive Pressure Ventilation (nIPPV). It is unknown which type of nCPAP/nIPPV device is most effective.
Objective: To analyze the effect of three nCPAP/nIPPV systems, compared to a standard ventilator in nIPPV mode, on bradycardia and desaturation.
Study design: 16 infants (mean gestational age at study 30.6 wk) were enrolled in a crossover trial. They were randomly allocated to receive nCPAP/nIPPV for 6 hours each, using either our standard ventilator in nIPPV mode (StephanieTM), the Infant FlowTM device in nCPAP-mode, the Infant Flow AdvanceTM system in nIPPV mode or an underwater bubble-CPAP system. Chest and abdominal wall movements, pulse oximeter saturation and electrocardiogram were recorded. Primary outcome was the cumulative rate of bradycardia and desaturation events per hour.
Results: The median event rate was 6.7/h with the StephanieTM, compared to 2.8/h and 4.4/h with the Infant FlowTM or Infant Flow AdvanceTM system (p<0.03). There was no significant difference to bubble-CPAP (5.4/h).
Conclusion: The Infant FlowTM Driver was found to be more effective in reducing bradycardia and desaturation in preterm infants than a system delivering nIPPV via a conventional ventilator.